Thanks,.

Once you submit the referral, we'll provide you with an update on your referral you every step of the way.

You can contact us any time with questions.

Thanks,.

Does the participant have a parent/guardian, legal decision maker or plan nominee?This question is required.

Please enter the participant Date of Birth.

Please enter the participant's NDIS number:

It's a 9-digit number that can be found on your online portal or NDIS plan.

, we truly believe that participants are not defined by their disabilities.

However, in order for us to ensure an effective service, we may need to ask about the participant's disability or condition.

Is there anything else you would like to let us know about the participant?

However, in order for us to ensure an effective service, we may need to ask about the participant's disability or condition.

Please tell us about the participant's presentation, condition(s) and/or diagnosis.This question is required.

Please select all that apply.

So, . How can we help?

Please select from one of the below support categories.

Allied Health and Therapies

(Psychology, Speech Therapy, Physiotherapy)

✓

Specialist (Positive) Behaviour Supports

✓

Disability Supports

(Assistance with Self Care, Community Access, SIL, Respite/STA)

✓

Support Coordination

(Level 2 & 3 Support Coordination)

✓

You've selected Allied Health & Therapy Services.

Click here to learn more about each type of Allied Health Service we offer.

Is the participant under the age of 7?

Unify are registered to provide Early Childhood Intervention Supports.We want to make sure your clinician will be the right fit.

Please select the required service(s).

If an option is not available, it may mean we do not currently have capacity for this service. Please contact us for more information. We promise to get back to you quickly.

How much funding for the selected service would you like to allocate?

Please enter the $ amount to be allocated.

How is this fund managed in the NDIS plan?

Let's talk about how we can deliver your services effectively.

We want to make sure we're helping you in the best way we can.

You're looking for services in Queensland.

Here's where we're you can find us:

i We can conduct home visits state-wide !

We make it convenient by offering different ways to deliver supports.

Select what you'd prefer.This question is required.

Choose as many as you like

We can come to you (Home visits)

✓

You can come to us (Clinic visits)

✓

We can connect online Telehealth

✓

We know some participants have preferences.

We try to ensure that participants are matched with team members who suit their needs and preferences.

Please select your gender preference for your allocated team member(s):

Is this preference a firm requirement?

We're almost done. Thanks for assisting us with the information.

Please enter the email of the person who will be signing the service agreement.

We'll send through a service agreement via email for electronic signing, which means you can complete it paperlessly, and from the convenience of your device.

We recommend uploading a copy of the NDIS Plan . This helps us process your information correctly and quickly, as well as learn your goals to help you achieve them

We understand participants may not want to share their NDIS plan. Feel free to share snippets, or simply ignore this step.

Choose file or drag here

Size limit: 10MB

Feel free to share any additional documentation you feel might be helpful.

Common uploads include: Medical & Allied Health Reports, Behaviour Support Plans, Participant Profiles, Risk Assessments & Safety Plans.

Choose file or drag here

Size limit: 10MB